Is PrEP Reaching Everyone?

Eliminating the skepticism and shame in minority communities.By James Lee

Today there are new forms of HIV prevention on the market, including Pre-Exposure Prophylaxis or PrEP. PrEP is a preventative drug used to protect the body from HIV. If taken once a day, in addition to condom use, most patients can remain 100 percent HIV-free. Still, even with this advance in HIV prevention, many minority communities are hesitant.

“The medical community has preached the same conversation for so many years: condoms, condoms, condoms,” says Maya Ford, an expert in the field of PrEP marketing. “We know that condoms are effective when used properly, but in terms of behavior, they’re not always effective.

“Skepticism is a very healthy thing for survival,” says Ford. “I think it’s natural that we’re skeptical when we talk about an epidemic like HIV and how far it’s come.”

At first, Ford explains, she had a lot of questions before she trusted the science behind PrEP. “For so long, HIV was really stigmatized, and then after the stigma, it went into a livable phase. [So] PrEP seemed too easy—too good to be true.”

She explains that those in the Latino and Hispanic communities, as well as the African-American communities, are also skeptical. In addition to a general distrust of pharmaceutical industry claims, minority communities often experience feelings of shame surrounding sexuality.

Across the board, Ford says, shame is a problem standing in the way of HIV prevention in the LGBT community. “What continues to surprise me, especially in the LGBT community, is the notion that PrEP will make one’s sexuality permissible.”

Ford goes on to explain how she has come to realize the level of shame surrounding PrEP usage through her work. “I was very surprised by that, especially in the LGBT community, because we [should be talking] about sexuality as though it’s our own right and our own business. And so the notion that we bring in traditional patriarchal values is quite upsetting,” Ford explains.

She goes on to say that these attitudes lead minority consumers to believe they need to explain why they would like to be on PrEP, which sometimes prevents those in minority communities from doing so. “It’s not [anyone else’s business],” Ford explains. “The public’s interest is in epidemiology and ensuring that we provide every possible method of preventive care, with regard to HIV prevention.”

Ford explains how cultural norms in minority communities, and the shame surrounding homosexuality, place heterosexual women, transgender women, and cisgender men who have sex with men (but do not classify themselves as gay) at greater risk of becoming HIV-positive.

Still, she explains, even with the cultural social norms working against the drug’s acceptance, “PrEP is revolutionizing that conversation—[if] we are able to frame it properly.”

Through her previous work at Legacy Community Health, Ford was able to effectively combat negative influencers through two marketing campaigns. The first was “It Doesn’t Matter What You Call It.”

Through the campaign, Ford explains her team used street names and colloquialisms like “smashing,” and other terms for sex, helping those in affected communities identify with the campaign. She elaborates on the thought process behind the “It Doesn’t Matter What You Call It” campaign: “It doesn’t matter how you want to frame this, it matters that you want to be safe and use PrEP.”

Following this success, Ford created “dOWN it,” an even broader campaign that yielded effective results. The campaign’s marketing material features a simple glass of water next to a little blue PrEP pill with the words “down it” across the image. The ad, calling for the viewer to own their health, then reveals the words “OWN it” as the glass of water transforms the phrase.

“It’s your life, it’s your body, it’s your right,” she tells me. “I think those conversations appeal to people because it’s a very simple notion—a glass of water and your ability to control how and when you take it, and there’s no people involved. That’s the beauty of PrEP—it’s complete self-ownership.”

Drawing from her success, Ford hopes to take what she has learned nationally and help community health centers better markettoward minority communities and women, through her firm, FordMomentum!

Ford explains that she believes PrEP usage may increase among minority communities when healthcare providers begin to better market toward women of color. “Interestingly, in the Hispanic community, women are the permission-givers. So you have a very high chance of reaching Hispanic men through the permission giver, who is the woman.”

Ford says that a lot of the stigma surrounding PrEP is cultural. “I don’t think we have enough culturally comfortable people who are diverse enough to have this conversation yet. But I’m here to rally the charge. That’s my mission in 2016, and I’m really thrilled about it.”

“[The discussion around PrEP] is aligned with sexual freedom, or the lack thereof. I do think in the future when women begin to own it, much like birth control, we are going to see it as another tool for empowerment and for us to be prepared for life. It’s a beautiful revolution.”

James Lee is the Public Affairs Field Specialist at Legacy Community Health and focuses on minority health, mental health, and civic engagement. Lee is an alumnus of the University of Houston and can be found on Twitter @jamesmateolee.